Provider Demographics
NPI:1982835047
Name:HOVDA, SUZY MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:SUZY
Middle Name:MARIE
Last Name:HOVDA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 CAPETOWN CIR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-6303
Mailing Address - Country:US
Mailing Address - Phone:949-375-1221
Mailing Address - Fax:949-722-0402
Practice Address - Street 1:1801 CAPETOWN CIR
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-6303
Practice Address - Country:US
Practice Address - Phone:949-375-1221
Practice Address - Fax:949-722-0402
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38638106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist